Nasogastric tube feeding

Jays george
Msc Nursing

1. NASOGASTRIC TUBE FEEDING SUBMITTED TO , MRS .PRICY JIMMY CLINICAL INSTRUCTOR D .Y .P .S .O .N SUBMITTED BY , MISS . JAYS GEORGE 1 ST YR MSC (N) D .Y .P .S .O .N

2. DEFINITION Administration Of Feed Directly Into The Stomach Through A Tube Passed Into The Stomach Through The Nose (Nasogastric) Or Mouth ( Orogastric )

3. PURPOSE To Provide Adequate Nourishment To Patient Who Cannot Feed Themselves. To Administer Medication To Provide Nourishment To Patients Who Cannot Be Fed Through Mouth. E.G. ; Surgery In Oral Cavity , Unconscious Or Comatose State

4. INDICATIONS Head And Neck Injury Coma Obstruction Of Oesophagus Or Oropharynx Severe Anorexia Nervosa Recurrent Episodes Of Aspiration Increased Metabolic Needs – Burns ,Cancer Etc. Poor Oral Intake

5. TYPES OF NASOGASTRIC TUBE LEVINE'S TUBE

6. SALEM SUMP

7. ARTICLES A Tray Containing ; Formula Feed Graduated Container Large Syringe(30 To 60 Ml) Water In Container Stethoscope

8. GRADUATED CONTAINER LARGE SYRINGE (60 ML)

9. PROCEDURE NURSING ACTION Identify Patient And Explain Procedure To The Patient And That Feeding Will Take Around 10 – 20 Minutes To Complete, Also Explain That Patient Will Experience A Feeling Of Fullness After Feeding. Assess The Food Allergies, Time Of Last Feed , Bowel Sounds And Laboratory Values. RATIONALE Proper Explanation Allays Anxiety And Ensures Cooperation , Explanation To Be Given To Patients Who Are Comatose Or Unconscious As They May Hear And Perceive The Instructions. Proper Assessment Will Prevent Risk Of Complication.

10. Place Container With Feed In Warm Water. Assist Patient To Fowlers Position. Wash Hands Spread Towel And Mackintosh Over Patients Chest. Done Gloves Attach Syringe To Nasogastric Tube. Warms The Fluid To Be Fed. To Enhance Gravitational Flow Of Feed Through Tube End Prevents Risk Of Aspiration. Reduces Risk Of Transmission Of Micro-organisms

11. Aspirate Stomach Contents If There Is Doubts About Tube Placement And Obtain An Order For X-ray. If Tube Placement Is Confirmed In Stomach , Pinch The Feeding Tube And Attach Barrel Of Feeding Syringe To Tube If Residual Gastric Contents Exceeds 100ml For Intermittent Tube Feeding Or Greater Than 1/5 Times The Hourly Rate For Continuous Feed And Notify Physician. Pinching Of Feeding Tube Prevents Air From Entering The Stomach And Causing Distension .

12. Fill Syringe Barrel With Water And Allow Fluid To Flow In Gravity , By Raising Barrel Above Level Of Patients Head. Pour Feed Into Syringe Barrel And Allow It To Flow By Gravity Keep On Pouring Feed / Formula To Barrel When It Is Three Quarters Empty, Pinch Tube Whenever Necessary To Stop When Pouring Water Clears The Tube And The Rate Of Flow Is Regulated By Raising Or Lowering The Syringe. Prevents Air From Entering Tube .

13. After Feeding Is Completed , Flush Tube With At Least 30 Cc Of Plain Water. After Tube Is Cleared Close The End Of Feeding Tube. Rinse Equipment's With Warm Water And Dry. Keep Head Of Bed Elevated For 30-60 Mins After Feeding. Prevents Clogging Of Feeding Tube. Prevents Leakage. Prevents Bacterial Growth. Prevents Aspiration

14. Wash Hand Document Type And Amount Of Feeding Amount Of Feeding, Amount Of Water Given And Tolerance Of Feed. Monitor For Breath Sounds ,Bowel Sounds , Gastric Distension , Diarrhoea Constipation And Intake And Output. Reduces Risk Of Transmission Of Micro Organism. Evaluates For Aspiration Effects On GI System And Therapeutic Effect Of Feeding.

15. Instruct Patient To Notify Nurse If He Experience Sensation Of Fullness , Nausea Or Vomiting. May Indicate Intolerance Of Feeding .

16. SPECIAL CONSIDERATION Change The Nasogastric Tube According To Institution Policy. Change The Articles Every 24 Hours Or According To Institute Policy.

17. COMPLICATIONS